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The ideologues on the far right may continue to scream for “repeal” of Obamacare, but the evidence continues to pile up that this is simply not something that’s going to happen. That was the analysis delivered by Judy Waxman of the National Women’s Law Center at this morning’s NC Policy Watch Crucial Conversation breakfast in Raleigh. Waxman noted that amendments to the ACA are certainly likely — indeed, she thinks they are essential — but based on decades of experience in Washington and her numerous political and policy contacts around the country, she believes repeal is simply not in the cards.

Waxman’s analysis is consistent with this AP story that ran on several North Carolina news sites this morning. This is from the version that ran in Raleigh’s News & Observer under the headline “GOP governors don’t see ‘Obamacare’ going away”:

Nine Republican governors have expanded Medicaid for low-income people in their states, despite their own misgivings and adamant opposition from conservative legislators. Three more governors are negotiating with the Democratic administration in Washington.

Rather than demanding repeal, the governors generally have sought federal concessions to make their decisions more politically acceptable at home. That approach is in sharp contrast to the anti-Obamacare fervor of their party in Congress.

Ohio Gov. John Kasich says he doesn’t think there will be a repeal in Washington, even if Republicans win a Senate majority and consolidate their hold on the House in next month’s election.

As the North Carolina NAACP holds a “Denial of Medicaid Funeral Procession” today, it’s worth considering some of the facts and data surrounding the impact of North Carolina’s ongoing refusal to expand Medicaid under the Affordable Care Act:

The North Carolina Institute of Medicine’s 2009 Access to Care study begins with this statement: “The lack of health insurance coverage is the foremost barrier to accessing health care services.”

In the report’s introduction it continues:

In a statewide survey of adults, nearly half of the uninsured in North Carolina reported forgoing necessary care due to cost, compared to 10% of individuals with insurance coverage. Lack of coverage also adversely affects health as the uninsured are less likely to get preventive screenings or ongoing care for chronic conditions. Consequently, the uninsured have a greater likelihood than people with coverage of being diagnosed with severe health conditions (such as late stage cancer), being hospitalized for preventable health problems, or dying prematurely. In fact, adults who lack insurance coverage are 25% more likely to die prematurely than adults with insurance coverage.

A Families USA report in 2010 estimated that before the Affordable Care Act passed nearly 1,000 North Carolinians died each year between 2005 and 2010 due to lack of health insurance.

What has changed is that the states now have an unprecedented tool for saving lives. North Carolina now has the opportunity to extend health insurance coverage to nearly all low-income adults, the majority of whom are working. The federal government will finance nearly the entire cost of this coverage expansion. Not expanding coverage is not only morally misguided but it is also fiscally irresponsible. Read More

Lest anyone have any doubt about what the real life impact is of the the McCrory-Berger-Tillis decision to refuse to expand Medicaid over the last two years, the NAACP will lead an event today at the Old State Capitol Building in Raleigh to remind folks:

“To dramatize the loss of life, healthcare, jobs, and hospitals due to the extreme and immoral denial of Medicaid Expansion, the people of North Carolina will come together on October 20th to hold a funeral procession around the State Capitol.”

What is the result of the Governor and General Assembly’s decision to block Medicaid Expansion?
• 27,044 diabetics not getting necessary medications
• 40,000 women not receiving recommended preventive screenings
• 14,776 more families receiving catastrophic medical bills
• 2,800 deaths that could have been prevented
• The rejection of $4.9 million per day by North Carolina’s Governor and General Assembly that would provide coverage to 500,058 uninsured people (since January 1, 2014)

Why North Carolina should expand Medicaid:
• It would extend insurance coverage to more than 500,000 North Carolinians.
• More than 300,000 of these people have no other insurance options.
• The federal government will fund more than 90% of this expansion.
• It would create roughly 25,000 jobs by 2016.
• It would bring in more than $2 billion in federal funds to the state every year.
• It would save North Carolina $65.4 million over the next 8 years.”

The Alliance for a Just Society along with Action NC released a report today titled “The Promise of Quality, Affordable Health Care for Women: Is North Carolina Delivering?” The answer, in a word, is no.

Overall the report gives our state a C- on women’s health when looking at a range of measures from health outcomes to access. Most abysmal is the state’s ranking on health insurance coverage. There we merited a D-. The uninsured rate among non-elderly women in NC is nearly 17 percent. There are also tremendous racial disparities in uninsured rates. Nearly 19 percent of black women are uninsured in the state, according to the report, and almost 39 percent of Latinas are uninsured. Our state ranks 50 out of 50 for uninsured rate among Latinas.

The grades don’t climb much higher from there. On women’s access to health services we earned a mediocre C and on health outcomes we get a C-. This is a report card we might want to hide in the couch cushions.

But there’s good news that could boost our lackluster scores. As the report recommends, expanding Medicaid would put a major dent in our uninsured rate, help close the health disparity gap, and improve outcomes.

NC lawmakers once famously claimed that Medicaid expansion has nothing to do with women’s health. This report card, and hundreds of thousands of women across the state, beg to differ.

In the end, however, there’s no mystery. The persistence of unemployment points to how badly the job market deteriorated and how tax cuts and spending cuts do little to restore it. North Carolina has cut taxes in a way that disproportionally benefits higher earners while expanding taxes or removing exemptions that helped middle-income and low-income earners and retirees. Tax breaks for the wealthy tend to go into savings while a tax break for lower income earners would have gone directly into the economy.

North Carolina’s cuts in state funding for education have an outsized impact on the economy. Unlike many states where local governments bear most of the cost of schools, North Carolina funds education primarily from the state level. Meanwhile, North Carolina’s refusal to expand Medicaid has cost the state’s economy billions of dollars in federal funds and reduced or blunted employment by hospitals.

There’s not much state government can do to escape the influence of the national economy. But states can do more to soften the effects of a national recession and speed the effects of a recovery. North Carolina should spend aggressively on education, participate fully in the Affordable Care Act and focus tax breaks lower down the income scale.

That’s not being done, and the economic pain is being extended.

Meanwhile, an editorial in the Charlotte Observer offers a glimmer of hope on this front in the form of additional confirmation from the McCrory administration that it has finally recognized one of its biggest blunders when it comes to pumping dollars into the state’s economy — the failure to expand Medicaid: